My Gyn also told me no need until 65. My PCP and I then discussed, and she ordered it based on the justification that I have a thin frame (weight less than 127 lbs or BMi less than 21 for this purpose) and am post menopause. Insurance paid, and I was diagnosed with osteoporosis at 52. Had I taken my gyn’s advice, I would not have known until much later and more bone lost. Perhaps your doc can get approval if you identify risk factors (thin frame, family history, certain meds, maybe others). If not, it could be well worth it to pay out of pocket if you are able. At the facility I went to, the cost would have been less than $500.